The purpose of a Specialized Center of Research at Duke University is to investigate the pathogenesis of events which contribute to disability and death from ischemic heart disease and to evaluate new and improved methods of prolonging life and reducing disability in these patients. The SCOR approaches these objectives through research directed at each of the major manifestations of ischemic heart disease. Studies are underway to improve and evaluate the medical and surgical treatment of angina pectoris, to reduce the extent of myocardial damage and improve the survival of patients with acute myocardial infarction, to improve the techniques for surgical intervention in ischemic heart disease, and to extend the application of surgical therapy to the treatment of heart failure and arrhythmias, to investigate further the factors which contribute to an increased risk of sudden death and, finally, to improve both the methods and information content of noninvasive approaches to the evaluation of patients with ischemic heart disease. Data from all patients with ischemic heart disease, including detailed baseline descriptors, treatment and outcome, are recorded in a computer-based information system, which facilitates our research and will ultimately permit doctors to tell each new patient with ischemic heart disease what medicine can and cannot accomplish for him. The SCOR represents the major instrument for funding and integration of clinical research on ischemic heart disease at Duke. This program represents our commitment to continue the successful components of the Myocardial Infarction Research Unit, to expand the scope of selected projects and add new areas of investigation relevent to the border goals of the SCOR program.